In people aged 75 or over, long-term daily aspirin use is linked to a higher than expected risk of bleeding, according to a new study in The Lancet.
While short-term aspirin use after a stroke or heart attack has clear benefits, researchers that we part-funded found that patients over 75 who take aspirin on a daily basis should be prescribed heartburn drugs to reduce the risk of bleeding.
Roughly 40-60% of adults aged 75 or older in the USA or Europe take daily aspirin or other antiplatelet drugs to prevent heart attacks or strokes. Lifelong treatment with antiplatelet drugs is recommended for patients who have previously had a heart attack or stroke.
Risk increases with age
The Oxford Vascular Study followed 3166 patients who had previously had a stroke or heart attack and were prescribed antiplatelet drugs (mostly aspirin). Half the patients were aged 75 or over at the start of the study. Over 10 years of the study, a total of 314 patients were admitted to hospital for bleeding. The risk of bleeding, in particular the risk of fatal or disabling bleeding, increased with age.
An important part of the armoury
Professor Sir Nilesh Samani, our Medical Director, said:
“For some patients aspirin is an important part of our armoury to prevent heart attacks and strokes. But we have known for a long time that it is associated with an increased risk of bleeding particularly from the stomach and this can sometimes be very serious.
“This research is an important step forward as it shows that the risk of bleeding is substantially higher in people over 75 years and that older people who require aspirin may particularly benefit from also being routinely given heartburn drugs which protect the stomach.
“This will help to reduce the risk of bleeding while helping to retain the cardio-protective benefits of aspirin.”
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